Health in the Western World

General Discussion
1

Happy Thanksgiving to those who celebrate it – and to those who don’t.

Sadly, the often-interesting Scott Locklin sees nothing in the world of US health care to make him celebrate. His piece could be taken as a Cri de Coeur for the now vanished country in which he grew up; but the issues he raises seem generally to be endemic throughout the Western world.

Locklin on science | In which I explain things interesting, remarkable or silly. (wordpress.com)

With a little paraphrasing, here are Mr. Locklin’s issues about health in the US:

  1. Widespread obesity, with attendant health problems which dwarf Covid.
  2. Increasing numbers of people with mental health issues.
  3. Hormonal disruptors, masculizing women and feminizing men.
  4. Astonishing growth in autism, from 1 in 10,000 in the 1970s to 1 in 54 today.
  5. Growing numbers of people who claim to have serious allergies.
  6. Widespread drug use, both illegal and prescribed.
  7. Failure to recognize the rapid drop in female fertility after their early 30s.
  8. Public health officials sacrificing trust by being liars and fools.
  9. Sudden appearance of insanitary tent cities/favelas for the “homeless”.
  10. The very high costs of the US health industry.

The interesting question one might ask is – Are these issues the real problems? Or are they symptoms of underlying causes? And, if so, what are those fundamental causes?

Whether we are talking about medicine or automobile repair, accurate diagnosis is the essential first step towards dealing with the problem.

To be controversial, the growth in the health problems mentioned by Locklin correlates well with the decline in smoking since the 1970s. It is a common observation that people who stop smoking are at great risk of putting on weight – and obesity seems to drive a lot of other health issues (including even susceptibility to the Dreaded Covid-19). If Dr. Fauci suddenly reversed course (again) and stated that Science demands that everyone start smoking as well as getting “vaccinated”, would anyone pay attention?

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2

There are some more fundamental problems. Physicians have been reduced to “provider” status, now equivalent to NP’s and even PA’s. Hospitalist shave replaced the primary care physician and hospitals now OWN the majority of “outside” practices.

?So who’s actually RUNNING the “health care system”. Well, hospital administrators and insurance companies, whose main drive is profit. Patients now are merely “profit centers”, as if their illnesses are of no consequence.

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3

Esther Dyson, a celebrated tech entrepreneur and investor, has worked on https://wellville.net/ – a project with this 2016 mission:

Where Communities Cultivate Health: They’re focused on the things determining the odds people get sick in the first place, and they’re taking cues from other industries that have been disrupted and transformed. They’re learning how to apply the best of what works at scale. And about being entrepreneurial, not just to improve care but to cultivate health. They are on the way to Wellville.

One of the places was Muskegon, Michigan. When the project was underway in 2016, they had these focus areas on the archived website:

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They established these metrics:

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They also tracked the stats:

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… fast forward 8 years …

The new Wellville copy states:

Five Communities Improving Equitable Wellbeing: Wellville is a 10-year national nonprofit project to achieve long-term, equitable, community wellbeing. We serve as a catalyst for five US communities – the Wellville 5 – as they work to improve their health and wellbeing through resident-centered, multi-stakeholder collaboration. The Wellville 5 will inspire other communities to copy (and improve upon) their work and to promote change in how our nation invests in its people, institutions and systems.

The dashboard hasn’t changed, still showing data from 2017. The news, however, state https://detroitpraisenetwork.com/2023/08/28/7-michigan-cities-hit-high-obesity-rates-study-finds/ :

Muskegon Heights holds the second position on the list, with a population of over 10,500 and an an obesity rate of 55.5% among adults, one of the highest in the study.

The initiatives are extensive:

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Another place, Clatsop County, Oregon, had the following priorities:

Initial Focus Areas

  • Decrease chemical dependency
  • Improve mental health

It might have even worked the first year:
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Here’s the new set of initiatives:

Clatsop Equity Committee
A group of local stakeholders are working to identify sustainable long-term initiatives to improve equity. The group is also growing the impact and influence of the Committee, including by publicizing its work in local media.

Regional Health Equity Coalition (RHEC) designation
Stakeholders from Clatsop, Tillamook and Columbia counties are collaborating to apply for an RHEC designation from the state. RHECs are collaborative, community-led, cross-sector groups organized regionally to identify and address health equity issues. Coalitions prioritize communities of color as primary populations of focus.

Pre-kindergarten (pre-k) slots
The team engaged Social Finance and the Sorenson Impact Center to complete a feasibility study for a pre-kindergarten Pay for Success program. While Pay For Success wasn’t viable, the process gave the County valuable data and relationships for adding pre-k and child care slots. The team is working on other angles for a smaller-scale expansion of pre-K.

Even smart people with good intent - fail with some of these ‘communities’. The trappings are visible from the above:

  • abandonment of metrics
  • expansion of initiatives
  • backslapping
  • organizational takeover
  • modern trendy lefty politics
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4

Price opacity is a problem especially if insurance won’t cover it. From a profit perspective hospitals and doctors should encourage cash or first party payment.

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5

THAT was, indeed, true in the rural communities. Many a town doc was paid in chickens, eggs, crops, etc. That was what that community raised, so in a sense, that was the “coin of the realm”.

Look back at our monetary history. Congress is allowed to set weights and standards - for silver - NOT gold. The thinking was that ordinary people didn’t have access to much gold, while silver was relatively common. So Congress is allowed to establish standards for coinage. Of note should be that Congress is NOT allowed to issue “paper money”. That becomes the basis for our current two-step of selling bonds to the US Federal Reserve Bank; they purchase the Fed bonds then issue the paper. They being a private bank, their perspective will be more self-preservation than boondoggles.

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6

It wasn’t just the radio ads that gave Gammage fits, but also Paul’s intimate relationship to so many voters in a sizable chunk of the congressional district. Especially the mothers.

“I had real difficulty down in Brazoria County, where he practiced, because he’d delivered half the babies in the county,” Gammage says. “There were only two obstetricians in the county, and the other one was his partner.”

Ron Paul, MD

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